Naslov
Incidence of PONV : Is 50% Nitrous Oxide Friend or Foe?

Autori
Šimurina, Tatjana ; Mraović, Boris ; Sonicki, Zdenko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of The Annual American Society of Anesthesiologists meeting ; u: Anesthesiology 61 (2006) (S) ; A1401 / - Chicago (IL) : Wolters Kluwer ; Lippincott Williams and Wilkins, 2006, 105-105

Skup
Annual American Society of Anesthesiologists meeting

Mjesto i datum
Chicago (IL), Sjedinjene Američke Države, 14.10.2006. - 18.10.2006

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
nitrous oxide; postoperative nausea and vomiting

Sažetak
Recent meta-analysis showed that nitrous oxide (N2O) significantly increases postoperative nausea and vomiting (PONV) in patients with high risk for PONV in gynecologic laparoscopy (1). Controversy exists if 50% N2O has less incidence vs 70% N2O. This randomized, double-blind, prospective, controlled study compared the incidence of PONV in patients underwent general anesthesia for gynecologic laparoscopic surgery. After obtaining IRB approval and informed consents, 111 females classified as ASA I and II, 19-75 years old, scheduled for laparoscopic gynecological surgery were included in the study. The exclusion criteria were: obesity, gestation, diabetes, gastrointestinal paresis, use of antiemetics, steroids and psychotropic drugs before surgery. Anesthesia was induced with thiopental 5 mg/kg, vecuronium 0.1 mg/kg and fentanyl 1-2 μ g/kg, followed by 10 mL/kg saline and maintained with sevoflurane. After induction patients were randomized to receive: air with 30% oxygen (Group 1, n=37), 50% N2O with oxygen (Group 2, n=39) and 70% N2O with oxygen (Group 3, n=35). Total number of PONV episodes was recorded. During first 24 h post op. diclofenac IM and pethidine IV were used for postoperative pain and metoclopramide IV for PONV. No PONV prophylaxis was given. Data were analyzed using Χ ² ; , Fisher's exact, Kruskal Wallis and Mann-Whitney test and expressed as median and range. P<0.05 was considered significant. Age, weight, height, BMI, phase of menstrual cycle, history of smoking or motion sickness, duration of surgery and anesthesia were no significantly different between groups. Incidence of PONV was G1=12 (32%), G2=19 (49%) and G3= 24 (69%) with the overall significant difference (p=0.009). G1 vs G3 (p=0.006) was significant, but no significance were in G1 vs G2 (p=0.447) and G2 vs G3 (p=0.252). Treatment with metoclopramide was not significantly different between groups: G1=4 patients, G2=8 and G3=8 patients. Average pain VAS scores at 2h post op. were in G1 20 (0-58), G2 25 (4-60) and G3 25 (0-60) (p=0.25) and 24 h post op. in G1 5 (0-29), G2 14 (0-35) and G3 10 (0-40) (p=0.07). Total amount of opioids given perioperatively was not different between groups: G1=3 patients received pethidine (total 250 mg), G2=8 (325 mg) and G3=7 (350 mg). Our data shows that N2O increases incidence of PONV after gynecologic laparoscopic surgery. Decreasing N2O from 70% to 50% decreased incidence but not significantly. Larger patients groups might show statistically significant difference, but small difference, even if it is statistically significant, might not be clinically relevant, since, perioperative goals are to have lowest PONV incidence as possible to increase patients satisfaction with anesthesia and decrease rate of readmission. We do not recommend use neither 50% nor 70% of N2O in gynecologic laparoscopic surgery.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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